4719 Hazeltine Lane - COC41 City of Baran
White Copy: Property Owner
SANITARY SEWER SYSTEM
CERTIFICATE OF COMPLIANCE for
INFLOW & INFILTRATION
City of Ea gan, Minnesota
Pr operty Address: 41 / 7
COMPLIANCE WITH INITIAL INSPECTION
`, Ihis is to certify that the property listed above has been inspected by authorized City personnel on /06 , 201
and found to be in compliance with Section 3.40 of the City Code and no corrective work was required
COMPLIANCE AFTER CORRECIIVE WORK PERFORMED
Ihis is to certify that the property listed above has been found to be in compliance with Section 3 40 of the City Code
after satisfactorily completing the required corrective repair wor under (check all that apply):
n City Sanitary Sewer Permit City Plumbing Permit
Print name
NOTE Applicable only if box is checked: FiBased on a review of the Sewer Service video inspection /report on file, it is
recommended that periodic cleaning or future inspections beperformed to minimize a potential blockage due to.:
Grease Build -up, Root Intrusion, Dip /Settlement in Pipe, Other.:
i ) /l l f_ .•__L- / 1 ��
Date
Signature
Yellow Copy: City of Eagan (Parcel File)
41 City of Evan
rev 2 23.